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Episode 6 – Diagnosing ADHD

Transcript

Lindsay Guentzel (00:06):

How do you diagnose ADHD? And what are healthcare providers even looking for? This is episode six of Refocus with Lindsay Guentzel. And today, we are diving right into those questions with Dr. Gregory Harms. Dr. Harms has worked in the mental health field for over 20 years.

Lindsay Guentzel (00:24):

And in addition to being a licensed clinical psychologist, he’s also a certified alcohol and drug counselor, and he’s been with ADHD Online since 2018. He holds a master’s degree in mental health counseling and a doctorate in clinical psychology.

Lindsay Guentzel (00:37):

And he’s trained in multiple medical settings. He’s also currently working as a health psychologist with healthcare facilities in Illinois. And he also runs his own practice in Chicago. I’m your host, Lindsay Guentzel. And this podcast is a collaboration with ADHD Online, a telemedicine healthcare company providing ADHD assessments that are both accessible and affordable.

Lindsay Guentzel (00:58):

They also offer medication management and teletherapy resources in a growing list of states and are continuously working to add more to their database. I was diagnosed in January of 2021 through my primary care provider.

Lindsay Guentzel (01:11):

And one of the only reasons I even pursued it was because at the time I had health insurance. I was unemployed throughout most of 2020 because of the pandemic. And that meant I qualified for insurance through the state of Minnesota.

Lindsay Guentzel (01:24):

I truly think my questioning and curiosity surrounding ADHD popped up at the perfect time because I had the resources I needed to ask questions. And that privilege isn’t lost on me. But it shouldn’t take the stars aligning in the middle of a pandemic for us to be able to advocate for ourselves.

Lindsay Guentzel (01:44):

And that’s why I’m so passionate about the work ADHD Online is doing. My ADHD diagnosis was life changing in so many ways. Some, I’m still learning about. But it took a lot of heartbreak, a lot of dark moments to get through to the light.

Lindsay Guentzel (02:00):

And I realize some of this might sound so unbelievably cliche. If this podcast helps one person find answers, if it helps one person avoid the path I went down, that is truly my only goal in all of this. And you can add another tally to my growing list of cliches, but it feels like this is what I’m supposed to be doing.

Lindsay Guentzel (02:23):

That all along I was working to get here, I just didn’t know it. And I have been so overwhelmed in the best way by those of you who have not only welcomed me and this podcast into your lives, but those who have responded and shared such kind and thoughtful words with us, me and the team at ADHD Online.

Lindsay Guentzel (02:46):

I’d be lying if I said I didn’t enjoy hearing those good things, because this podcast means a lot to me. And I know there is still so much growth ahead of us. I’m still incredibly proud of what we have created so far and what we’re sharing with you.

Lindsay Guentzel (03:05):

There are so many plans for the future of this podcast, and we’re hopeful you’ll join the conversation about what you want to hear as we continue to move forward. You can email the show directly at podcast@ADHDonline.com. And if you’re enjoying Refocus with Lindsay Guentzel, take a minute to subscribe, rate and review wherever you’re listening now.

Lindsay Guentzel (03:26):

It might seem unnecessary, but it actually helps increase the reach of this podcast, and it helps introduce more people to what we’re doing. And as many of us know, sometimes you have to hear or see something to connect it back to your own life. And I think that’s even more true with a disorder as complex as ADHD. You don’t know what you don’t know until you do.

Lindsay Guentzel (03:46):

And like I said, I hope this podcast can be the catalyst for anyone who needs it. As I mentioned, this episode of Refocused with Lindsay Guentzel looks at diagnosing ADHD. And you may have already met my guest through one of the webinars he’s done through ADHD Online. In fact, Dr. Gregory Harms just hosted a webinar on this exact topic, which you can find by visiting ADHDonline.com\webinars.

Lindsay Guentzel (04:30):

Hey there, Dr. Harms. It’s so nice to talk to you. Thank you so much for joining me today.

Dr. Gregory Harms (04:35):

Yes. It’s my pleasure. Thank you.

Lindsay Guentzel (04:36):

I’ll be honest, outside of my own experience, I don’t know much about what actually goes into the diagnostic process. And I don’t even know if I’m saying it correctly, if I’m using the right terminology.

Dr. Gregory Harms (04:49):

Yes. So there’s a lot of different things that we look at. There’s a few different ways a diagnosis can be made. But really what I look for when I’m reviewing the assessments with ADHD Online, or if I’m meeting with a client at my private practice, what I want to see is what’s the history of the problems that we think ADHD might be causing.

Dr. Gregory Harms (05:10):

Because the whole key to a diagnosis is the person’s age when the problems first started. ADHD is kind of a lifespan condition. It starts early on, and no contrary to what we used to assume, it does kind of continue on throughout the lifespan in some form. It may moderate somewhat, some of the symptoms may change over time, but it’s generally there across the lifespan.

Dr. Gregory Harms (05:39):

It used to be believed it would kind of burn out or moderate kind of into teen years and by adulthood it would kind of disappear. And we’re just really finding that is not the case. It does continue. But we really want to see, did those symptoms begin at some point in childhood.

Dr. Gregory Harms (05:55):

And that can manifest in any number of different ways, like were they zoning out in school, did the teacher have to call their name multiple times to get their attention, did they have a messy desk, now was there room at home messy, did they have difficulty remembering to do their chores without having to be prompted multiple times?

Dr. Gregory Harms (06:13):

Or did they kind of give up on a chore halfway through and go on to something else and never kind of looped back? We want to kind of see those behaviors starting very early on and then progressing in some form across the lifespan. If they started later in life, like in the teen years, or even in adulthood, it’s not to say they’re not having those problems, but it’s something other than ADHD is what’s causing those problems.

Dr. Gregory Harms (06:40):

So I really want to see that history and see some sort of evidence, whether it’s the individual’s own memory of things, do they have report cards that had really commented on their behavior in class, do their parents tell stories about their behaviors as a kid, do their siblings remember things that they did that indicated these problems were there? And really get that history.

Lindsay Guentzel (07:02):

One of the things I find interesting is that since my own diagnosis and these interviews I’ve done, I’ve heard over and over again that the symptoms have to have presented themselves before the age of 12. But that’s a newer age.

Lindsay Guentzel (07:17):

It used to be before the age of seven. And then they realized that adolescents, that middle school time, when a lot of us were given more responsibility and more independence, that was too much for some of us.

Dr. Gregory Harms (07:29):

Yes, exactly. That was one of the biggest complaints about the previous set of diagnostic criteria. And just for anyone who doesn’t know, pretty much all human medical, mental health conditions have an associated diagnosis in this gigantic list compiled by the World Health Organization called the ICD.

Dr. Gregory Harms (07:50):

And then psychiatrists and psychologists use a subset of those that focus more on kind of mental and behavioral conditions called the DSM or the diagnostic and statistical manual. And that book lists kind of all the different conditions people can have, whether it’s ADHD, depression, anxiety, bipolar disorder, Alzheimer’s disease, anything that can kind of impact the brain.

Dr. Gregory Harms (08:15):

And it lists a number of symptoms that need to be seen to kind of confirm the diagnosis that this is the condition this person has as opposed to any other different types of conditions. So when we refer to diagnostic criteria, we’re referring to that list in the DSM.

Dr. Gregory Harms (08:30):

And of course, the DSM has been around for a long time and it’s gone through many different revisions. And the previous edition had that seven year kind of limit on the symptoms had to be there before then. And that was a big source of contention among practitioners, because we know at that age, there’s a huge variability in behavior.

Dr. Gregory Harms (08:50):

Everyone develops differently. What’s considered normal is a very broad range. And so it’s really hard to pin down. Know if someone doesn’t seem to be paying attention, if they seem to be kind of hyper or impulsive, that still could be normal for that age. And it’s not really all that problematic until it gets extreme.

Dr. Gregory Harms (09:11):

So then the current edition of the DSM bumped that age limit up to 12, where we start to see behavior starting to converge into a much narrower range of what’s considered usual, or as much as I hate the word, normal. We can definitely see people that fall outside of that are much more easier to identify.

Dr. Gregory Harms (09:30):

And I know that was a huge sigh of relief among practitioners to kind of see that bumped up. And there’s a lot more research support for using 12 as the cutoff rather than seven. And then we really see through that research that when things do start showing up later than 12, it really is usually due to some other conditions of ADHD. So we were very happy to get that changed for the current DSM.

Lindsay Guentzel (09:54):

And one of the things that you mentioned when you were talking about things that are apparent for young children, for getting school assignments or having a messy desk or a messy room at home.

Lindsay Guentzel (10:05):

I think one thing that stands out for me with those descriptions is that a lot of that can be controlled by the parents, by the people at home who are setting up what could essentially be viewed as coping mechanisms for these children.

Lindsay Guentzel (10:19):

If you have parents who are on top of things and have a great understanding of what your schedule is each week and what you have to turn in and when the parent permission slip is due, that can hide some of these symptoms.

Dr. Gregory Harms (10:30):

Absolutely. And so that’s why part of the diagnostic criteria is we need to see these symptoms occur across multiple settings. So yes, the symptoms may be more controlled by the parents at home, but then the child gets to school where the teacher is trying to manage 30, 35 kids all at once. And those symptoms are going to kind of flare up again.

Dr. Gregory Harms (10:50):

Or they go over to a friend’s house, and then that friend’s parent calls the parents and be, “No, you’re not going to believe what this kid is doing while they’re over here.” Or you drop them off at Sunday school, and the Sunday school teacher rolls their eyes when the kid walks in, because they’re running around being disruptive.

Dr. Gregory Harms (11:08):

So we kind of want to look for those signs that this is happening outside that support. But then you also bring up a good point with that, that that’s where I tend to get a lot of people coming in, kind of in college, just after college with their first job kind of embarking on adulthood.

Dr. Gregory Harms (11:25):

And it can seem like these symptoms are all of a sudden sprouting up now in adulthood because the parents provided that structure and that control over the symptoms at home. And so that again, is where I really encourage someone if you’re thinking that this could be ADHD, if you’re really struggling, talk with your parents.

Dr. Gregory Harms (11:45):

Kind of ask them about what your childhood was like, because usually the parents would’ve seen something to then indicate, “We got to get these structures in place to make sure our kid gets through school, that they’re able to get grades that get them into a good college, that they can function.”

Dr. Gregory Harms (12:01):

And so the parents will then usually explain, “Yeah. We had to sit you down as soon as you got home. One of us was always with you while you were doing your homework. We had these kind of incentive programs for chores in place because otherwise you wouldn’t do them.” And there’s your sign that yes, these behaviors were there in childhood.

Dr. Gregory Harms (12:19):

So it’s really important to try to kind of talk to the important people in your life, get that information, and then you can relay that to your doctor. Or a lot of times doctors may even want to talk to those people as well and kind of get those stories to really show that these signs were there in childhood.

Lindsay Guentzel (12:35):

I’m curious because more people are being diagnosed later in life, what is bringing them in? What is pushing them to seek answers? Because I think for everyone it’s a little different. But for me, I didn’t know there was a problem. I just thought that was how I was. I didn’t realize that everything was more difficult.

Lindsay Guentzel (12:54):

It just kind of felt, “Yep, this is life.” And it was truly a post someone shared on social media, on Twitter that I saw and connected with. And like I said, I imagine for everyone it’s a little different, but what are you seeing when you’re speaking to people or when you’re going through some of the notes that you’re getting from patients through ADHD Online? What’s making people start to ask these questions?

Dr. Gregory Harms (13:17):

Yes. For the people that are coming in adulthood, they were never diagnosed as children kind of got through. A lot of times, it’s exactly what you describe, that they’re just kind of realizing as they’re moving up the career ladder, they’ve got more responsibilities, it’s getting harder and harder. When things were easier before it may be as you get more into middle age, maybe you’re getting divorced.

Dr. Gregory Harms (13:43):

And so again, you’re losing that support of having someone there with you to help you out, remembering where you need to be, or kind of doing things around the house to help out and make sure chores get done, errands get run, the kids get where they need to go. And suddenly you’re on your own for the first time in 20 some years.

Dr. Gregory Harms (14:01):

And you’re realizing it’s really hard to get all this stuff done. No one else I know seems to struggle with this. I don’t remember it being like this when I was with my significant other or when things were a little bit easier at work. Or maybe you’re taking on a leadership position in a social organization that you’re part of, like at church or in a professional association.

Dr. Gregory Harms (14:25):

And it’s, “Wow, I really can’t do this like I thought I could.” And then because of social media, which of course can be a double edged sword in so many ways. One of the good things about it is it does get a lot of this information out there that, “You’re not alone in this.

Dr. Gregory Harms (14:40):

This happened to me too. This is what it was for me.” And that can get people asking questions. And again, whether it turns out it’s ADHD causing it, whether it’s something else causing, it’s at least getting someone to come see a professional and start trying to get those answers.

Dr. Gregory Harms (14:56):

And again, we get that full history if we can see that it was there in childhood and just masked by a lot of these support structures and then as changes have happened over the lifespan, it becomes more and more apparent.

Dr. Gregory Harms (15:07):

We can say yes, “This really does seem to be ADHD. And now here’s what we can do about it to make life easier, give you the life that you really want to have, make it easier to function and really feel just much better about yourself and about your life.”

Lindsay Guentzel (15:23):

It’s interesting that you mentioned a divorce because that’s something I hadn’t thought about, but you’re right. When your coping mechanism is your other half, the person that you’re sharing your life with, I think the other example I find really interesting is retirement.

Lindsay Guentzel (15:37):

So my father passed away a few years ago at the age of 78, but he retired at the age of 62. And up until that point, he had a very intense routine. I mean, he was out the door every morning by 6:30, he was home at six o’clock. He was involved in the community.

Lindsay Guentzel (15:52):

He was involved in church. And all of these things kept his brain busy. But then the second he retired and that routine was gone, I think that’s really when we all started to notice the symptoms come out. And so it’s something that can be there throughout life and is somewhat controlled.

Dr. Gregory Harms (16:09):

Yes. That is the classic example of kind of how it can come out even later in life. And especially too, people that are retiring now, when they were in school, ADHD was never on anyone’s radar. A lot of kind of those behaviors were chopped up to as moral failings like, “No, this is a bad kid.”

Dr. Gregory Harms (16:30):

And then those were dealt with in rather specific ways that no, schools don’t always use now, although there are still a number of states where they do. And the kids would at least learn to start masking it, kind of rely on others for support, kind of create that life where they’re always on the go, they kind of get that busyness that they need so that they can look effective, kind of keep things in check.

Dr. Gregory Harms (16:57):

And then yeah, they retire, they kind of lose some of that. And then everything starts coming out in those kind of ways. And you can see that. And so retirement definitely is one of those milestones where all of these kind of hidden or somewhat managed behaviors then really start to get out of control.

Lindsay Guentzel (17:16):

How do you separate some of the things you would see in a childhood that could be ADHD versus childhood trauma? Because that’s something I’m seeing talked about a lot right now.

Dr. Gregory Harms (17:24):

Yes. That is definitely kind of one of the more difficult differential diagnoses to make. Normally again, sometimes we would’ve seen some of the behaviors coming out prior to the traumatic events starting. So there is some evidence that they were there and then the trauma happens. And of course, that makes things a lot worse.

Dr. Gregory Harms (17:42):

But if the trauma is happening kind of during that developmental period, it would be a bit harder to kind of tease out. And again, someone can have both, you can have both PTSD and ADHD or any number of other conditions. There’s no Karmic law that we can only have one condition or one bad thing happen to us in a lifetime.

Dr. Gregory Harms (18:01):

But PTSD or even just trauma that’s not full PTSD has some different symptoms that are not considered part of ADHD. So we would want to look for some of those as well like no, does the child seem to be maybe more dissociating and then kind of coming back and able to pay attention for a while and then might dissociate again?

Dr. Gregory Harms (18:22):

Or is that inattention more kind of continuous? Which would be an ADHD presentation. If it’s more episodic, that would probably be more trauma. Are they having nightmares at night? That’s not really ADHD, that’s trauma. Is there difficulty kind of around the bedtime routine?

Dr. Gregory Harms (18:41):

Have they regressed in any behaviors? Back to showing behaviors from a younger age. Did they kind of lose their toilet training, their wetting the bed, having more accidents, that’s more trauma as well.

Dr. Gregory Harms (18:53):

So we would want to look at that and see if that’s trauma and then say, we can say that that’s there. Maybe try treating the trauma, getting the child out of the situation, doing some trauma informed play therapy, things like that.

Dr. Gregory Harms (19:07):

And see then do those attentive and hyperactive problems start to go away or do those persist, which could indicate that it’s both. And then we can try some of the treatments for ADHD as well, and see if that results in some sort of improvement.

Lindsay Guentzel (19:21):

I’d be interested to know how you define trauma. Because I think I always had this picture in my head that trauma had to be this massive over the top something you would see in a movie or on an episode of Law & Order, just this mega moment in life.

Lindsay Guentzel (19:36):

And a friend described it to me a couple of weeks ago as anything that changes the way you behave. And I hadn’t heard it described that way before. And I don’t want to get too deep into this because this podcast is about ADHD, but I know that these can go hand in hand and trauma can exasperate ADHD symptoms.

Dr. Gregory Harms (19:54):

Oh, absolutely. Yes. So there’s many different forms of trauma. And something we can see too, is that ADHD symptoms might start showing up first. And in a very unstable family system, those could be dealt with in a very traumatic trauma inducing way with no severe physical discipline, emotional abuse, things like that.

Dr. Gregory Harms (20:18):

That can then cause the trauma reaction on top of the ADHD. So we can see that as well. But yeah, trauma can be a one time thing that is extreme or it can be ongoing. So it can be kind of continued abuse throughout childhood. It could be witnessing abuse.

Dr. Gregory Harms (20:34):

If a stepparent or someone comes in that’s abusive, they may be very abusive towards the child’s other parental figure, but not abuse the child. But growing up, witnessing that, knowing that it could, at some point get turned on you and growing up with that fear can be very trauma inducing.

Dr. Gregory Harms (20:54):

So witnessing substance abuse in the home can be trauma inducing, knowing that your needs are not going to get met, can be trauma inducing. Again, I think some of the discipline methods used in schools for prior generations could have been very trauma inducing as well.

Dr. Gregory Harms (21:10):

And again, some of those then could trigger some of those more ADHD like behaviors that may be more of a trauma reaction or they could be coming about because the adults were not understanding, not very supportive about those ADHD symptoms that were being displayed.

Lindsay Guentzel (21:28):

Telemedicine is a new concept for a lot of people, and the pandemic opened up a lot of those opportunities. And I imagine though that there are still some people who are very uncertain about how an online healthcare company works, if the telemedicine assessment matches the one you’d get in a doctor’s office in front of someone.

Dr. Gregory Harms (21:46):

Yes. So I love the process that ADHD Online uses. So I know I’ve mentioned this when I’ve done my webinars with them that when I first saw kind of job postings coming up for, “Do ADHD assessments remotely. This is great opportunity to do this.”

Dr. Gregory Harms (22:02):

I definitely wanted to look into it, but I was also a little bit skeptical about what I was going to learn. I’m, “Can that really be done? How thorough is this going to be?” And I was just super impressed from my first moment of contact with ADHD at how thorough they were in creating this assessment.

Dr. Gregory Harms (22:19):

They really kind of cover everything. So it really is kind of an online version of the interview that you would go through if you came to see me in my office, at my private practice. It gets at what’s the history of these symptoms.

Dr. Gregory Harms (22:35):

Do you have any other conditions that could be exacerbating them? Or if these behaviors started after the age of 12, are there signs of some of the other conditions like anxiety, bipolar disorder, OCD that might be the true cause of these symptoms?

Dr. Gregory Harms (22:51):

What is your use of substances like? Which for teens especially is a very important question. Has there been trauma? Kind of what is the functional impact at work in your social life, at home with these problems? And then screening for that list of symptoms in the DSM as well, to make sure those are there.

Dr. Gregory Harms (23:11):

And a lot of people will then comment at the end, we have a final box for is there anything else. And this took me three days to get through, but it’s so super thorough, I appreciate the detail. So it is quite lengthy.

Dr. Gregory Harms (23:22):

It takes a while to get through. It’s a big commitment. We do collect a lot of information. I would say kind of one of the things that’s different than if someone came to my office is that the ADHD online assessment is pretty much focused on a yes or a no for, are these problems being caused by ADHD?

Dr. Gregory Harms (23:41):

If it’s a no, we can kind of look at the data that was provided and say, it could be anxiety, it could be bipolar disorder. It could be untreated trauma. It could be the daily marijuana use. But there’s not enough information to conclusively say that’s what’s causing the problem.

Dr. Gregory Harms (24:01):

So all we can do is make some recommendations for future assessment. If it’s a no. Obviously, if it’s a yes, we can say yes, it’s ADHD. And then we can still say, “And it looks like you might have ADHD plus some anxiety and maybe the anxiety is a result of the problems of the ADHD, or maybe it is a separate condition.

Dr. Gregory Harms (24:20):

Maybe talk about that with the provider that you choose to see, kind of see what they say and keep an eye on these symptoms and see what happens with them.” So that’s probably the biggest thing. Sometimes I get people coming in saying, “I may think I may have ADHD.

Dr. Gregory Harms (24:33):

So I want to know that. And I kind of want to know how is it specifically impacting me? What might be some strategies?” And so we might do more of what’s called neuropsychological testing, which is giving people some brief tasks to do, like look at a series of pictures.

Dr. Gregory Harms (24:47):

And then 10 minutes later, you’ve got to kind of point out from a bigger set of pictures, which ones you saw. Or give you a list of words to remember. And 10 minutes later, repeat it back and do things like that. And then we can kind of pinpoint down where those specific problems are lying.

Dr. Gregory Harms (25:02):

And then we can make recommendations, especially if they want accommodations at work. If they’re going to take a college entrance exam or a graduate school entrance exam, and they want accommodations, we can use that data to make specific recommendations. For a diagnosis, it’s not always totally necessary to do that.

Lindsay Guentzel (25:25):

A huge thank you to Dr. Gregory Harms for sharing his experience with diagnosing ADHD with us. If you’ve missed any of his webinars, I highly recommend checking them out. You can find them at ADHDonline.com\webinars.

Lindsay Guentzel (26:14):

Like we do every week, we are going to bring Keith Boswell, the vice president of marketing at ADHD Online into the conversation. Bos, hello. Thank you for joining us.

Keith Boswell (26:25):

Absolutely, happy to be here as always.

Lindsay Guentzel (26:28):

So this episode is all about diagnosing ADHD. You and I both fall into the category of later in life diagnosis. And I’m curious if there are some things you would be comfortable sharing about the assessment you took through ADHD Online.

Keith Boswell (26:47):

Sure. I’d be happy to. It was very interesting. I had been with a therapist previously, probably about five years ago that said, “I think you have ADHD.” And I said, “Oh really? That’s interesting.” And she said, “No, really. I think you should get testing.”

Keith Boswell (27:06):

And for whatever reason, we just never got to testing. I never really pursued it. Because I think in my head, I just thought I don’t fit the bill. I don’t fit what I think of ADHD, the distracted hyper boy.

Keith Boswell (27:22):

But I’ll tell you, as I started to go through the assessment here at work, which I did both as an exercise and testing for us, but also as a personal, like I’m going to do this honestly and give my true history. And almost every question reaffirmed to me why I do have ADHD.

Keith Boswell (27:45):

I mean, as I reflected on things and looked at particular symptoms, it was very clear to me that it had always been there. It had always been a source of struggle, but I was attributing it to a lot of other things. And I think, I mean, those other things aren’t just don’t go away because ADHD is now identified.

Keith Boswell (28:11):

It was fascinating and eyeopening for me. It was like spending 90 minutes going down a very interesting mental trail of memories and thoughts and reliving moments where, when I thought about it in context of what they were asking, it was very clear what was going on. And it took about, I think my diagnosis took three days.

Keith Boswell (28:42):

And so I was a little nervous waiting because I was anxious. Is this real? Is it something I’m just perceiving? And because I work here now I’m thinking about it all the time. So when I got the diagnosis, it was reassuring in a lot of ways. Just because I think for me, it kind of confirmed what I was feeling during the test.

Lindsay Guentzel (29:04):

It’s kind of wonderful for you in a sense, you had this safety net because you were taking the assessment to make you a better advocate for the people you’re helping. But at the same time, you got these answers.

Keith Boswell (29:19):

It’s really opened up my understanding of myself in a way that I get more excited now talking to others about it. And I feel to your point, I can be more of an advocate because I don’t just know what we’re asking people, I’m living it.

Lindsay Guentzel (29:33):

So coming up at the end of the month on June 29th is the third and final webinar in the series that Lisa Woodruff from organized 365 has been putting on, which has been learning how to organize your home. And this webinar is specifically on the weight of paper. So we think of all the things that kind of bog us down in our house.

Lindsay Guentzel (29:56):

I’m really excited to see this series come full circle. And the best part about it is that at some point all three of them will be online. So if you’ve missed any of Lisa’s webinars so far, you can catch up, especially if you’re feeling motivated during summer vacation to get your house in order.

Keith Boswell (30:15):

You know that one of the highlights for me in the second webinar that she did with us was a phrase that’s really stuck with me, “We often overestimate what we can achieve in a weekend and then underestimate what we can achieve in a year to 18 months.”

Keith Boswell (30:29):

Lisa produced some really groundbreaking research about defining what housework is. Housework has always just kind of been this generalized thing. It’s sweeping, it’s cleaning, it’s laundry, it’s cooking. But as she really dove into it, most Americans are spending about the equivalent of part-time or full-time job on housework.

Keith Boswell (30:56):

Lisa’s a really great advisor on how to prioritize organizing. And again, this last one she’s kind of saving the mountain of paper for last, which is I think the thing we all look at, those receipts, the bills, the direct mail, the taxes you’re saving. I’m really looking forward to learning tips and tricks on getting that organized.

Lindsay Guentzel (31:27):

I want to wrap up today’s episode by sharing something I’ve been thinking a lot about lately. I just wrapped up my first season coaching for a running nonprofit where I worked with 20 girls in grades third, fourth, and fifth. And a lot of the curriculum was based on improving our self talk and being confident in who we are as individuals.

Lindsay Guentzel (31:50):

And one of the ways we did this was by doing an exercise where all of the girls had to write down nice things other people say or think about them. So things like, “My teacher thinks I’m a good helper” or “My best friend thinks I’m funny” or “My mom loves it when I help my younger brother.”

Lindsay Guentzel (32:12):

Kind of focusing in on how other people, the people we love and who love us and care about us, how those people view us. And I found myself repeating this line over and over to the girls.

Lindsay Guentzel (32:26):

I kept saying to them, “Wouldn’t it be so great if we saw ourselves the way those people see us? Think of what life would be like if we walked around with that kind of confidence.” And the more I learn about ADHD, the more I see the connection to my self-esteem issues. It’s a rollercoaster.

Lindsay Guentzel (32:49):

I mean, we’re talking the highest highs and the lowest lows. And I’m sure some of you can relate to that. But wouldn’t it be so great if we could see ourselves the way the people who love us, see us? If we could walk through life with that confidence, think of what would be possible.

Lindsay Guentzel (33:09):

And it’s so easy for me to push this advice on you, just like I did with the girls I was coaching. But my goal this week is to start pushing myself out of my comfort zone, to stop worrying about people who will just never get me or understand what I do.

Lindsay Guentzel (33:25):

And I’m going to work on focusing on the people who’ve made it clear that they appreciate what I am doing. And like anything in life that is hard, it is easier said than done. I know that. I know that I am not the first person to put this out into the universe. But I’m hoping that the more we hear it, the more likely we are to actually try and make it happen.

Lindsay Guentzel (33:48):

So find your good. Surround yourself with the people who lift you up, the ones who make you feel unstoppable. And while you’re working to make that happen, be kind to yourself. Grace goes a long way, especially when we show it to ourselves.

Lindsay Guentzel (34:13):

Refocus with Lindsay Guentzel is a collaboration between me, Lindsay Guentzel and ADHD Online, a telemedicine healthcare leader offering affordable and accessible ADHD assessments, medication management, and teletherapy. You can find out more by visiting ADHDonline.com.

Lindsay Guentzel (34:29):

The show’s music was created by Louis Anglais, a songwriter and composer based out of Perth, Australia, who was diagnosed with ADHD in 2020 at the age of 39. Once again, a huge thank you to Dr. Gregory Harms and Keith Boswell for joining me this week. Remember to subscribe, rate and review wherever you’re listening. Join us next week for another episode of Refocused with Lindsay Guentzel.

Our ADHD Online corporate office will be closed Thursday, November 24 and Friday, November 25 so our employees can enjoy this special time with their families. 

As always, you can still take our assessment at any time online, whenever and wherever is best for you.

Please note that each clinician sets their own holiday hours and may be processing your requests during this time or they may be out as well.

We will resume normal business hours Monday, November 28. Thank you for your understanding and patience as our staff enjoys time with family to celebrate the Holiday.

Behavioral Therapy

  • Florida
  • Georgia
  • Indiana
  • Michigan
  • Ohio
  • Oregon
  • South Dakota
  • Missouri
  • Texas
  • Tennessee
  • Virginia

Assessments

Assessment services are available in all 50 states.

Assessment and Treatment Plan Development & Implementation**

The patient completes our asynchronous assessment and receives the report from a doctorate-level psychologist within 3-5 days.

The patient schedules an initial appointment with one of our providers to develop a treatment plan through a secure virtual appointment.

The patient schedules subsequent follow-up visits with our providers for ADHD medical treatment or behavioral therapy.

**If available in your state

Assessment and
Treatment Plan Development**

The patient completes our asynchronous assessment and receives the report from a doctorate-level psychologist within 3-5 days.

The patient schedules an initial appointment with one of our providers to develop a treatment plan through a secure virtual appointment. We provide you and your patient with a copy of our full report. You take it from there.

**If available in your state

Assessment

The patient completes our asynchronous assessment and receives the report from a doctorate-level psychologist within 3-5 days.

We provide you and your patient with a copy of our full report. You take it from there.

Assessments available in:

All 50 states

Medical Treatment available in:

Arizona
California
Colorado
Connecticut
Delaware
Florida
Georgia
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky

Maine
Maryland
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Mexico
North Carolina
Ohio

Oregon
Pennsylvania
Rhode Island
South Carolina*
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
Washington, DC
Wisconsin

Teletherapy available in:

Georgia 
Michigan 
Missouri 
New Jersey 

Ohio
Pennsylvania
Virginia


*Prescriptions via telemedicine for Schedule II (stimulants) medications are not permitted by state law in South Carolina. Patients can receive prescriptions from our providers for non-stimulant medications. 

south carolina

Prescriptions via telemedicine for Schedule II (stimulants) medications are not permitted by state law in South Carolina. Patients can receive prescriptions from our providers for non-stimulant medications.